NICOLE MARIE WHITE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****57

License Status

NOT RENEWED

Business

Title

First Name

NICOLE

Middle

MARIE

Last Name

WHITE

Business Name

NICOLE MARIE WHITE MD

Original Issue Date

06/19/2012

Effective Date

06/11/2014

Expiration Date

07/31/2017

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017